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Biomedical subjects

J Rochemaure

Publications and source records attributed to J Rochemaure.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Combination of theophylline and beta-adrenergic agonists in the treatment of asthma: efficacy and tolerance. Review of the literature].

Theophylline and beta 2-mimetic agents have long been used concomitantly in the treatment of asthma, but divergent opinions are lingering on concerning the safety and effectiveness of this combination in both chronic and acute asthma. In this article, the effectiveness and safety of the combined treatment are reviewed on the basis of published experimental studies and controlled clinical trials. Altogether, these publications demonstrate that the combination is more effective in chronic asthma than either of the two drugs taken separately, but the results obtained are more discordant in acute asthma. Concerning the cardiovascular system, some experimental and epidemiological data have probably led to overestimate the cardiotoxicity of the combined treatment. In clinical studies the incidence of severe arrhythmia is low and certainly not higher than with a single drug therapy in both chronic and acute asthma. Owing to its safety, the theophylline-beta 2-mimetic combination can be prescribed widely in order to improve the treatment of the different forms of asthma.

Acute Disease↗
PubMed1989

[Pneumocystis carinii pneumonia in AIDS patients. Aspects of clinical evolution in 37 cases].

This study concerns 37 cases of Pneumocystis carinii pneumonia in AIDS patients. The time elapsed between human immunodeficiency virus (HIV) seropositivity and the onset of pneumocystosis has been established. Three clinical types are individualized. In cases with normal X-ray films of the chest, measurement of carbon dioxide transfer capacity, always reduced, has led to a bronchoalveolar lavage which provided an early diagnosis. In spite of good response to treatment, the prognosis of pneumocystosis is poor owing to the frequency of associated diseases.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Effect of a single dose of nifedipine on the CO transfer capacity in patients with scleroderma].

The calcium antagonists are currently used in the treatment of Raynaud's syndrome for patients with scleroderma. The effect on the pulmonary vasculature in these patients is little understood. The study reported here is based on 15 patients with scleroderma. In each patient lung volumes, expiratory flow and transfer factor (DLCO) were carried out in a basal state and one hour after the administration of sub lingual nifedipine. Nine patients showed a diminution in the DLCO before taking the product but the mean variation after nifedipine was not significant. Different mechanisms may explain the absence of any effect: irreversible vascular disease or the absence of pulmonary arterial hypertension or hypoxic constriction, the latter conditions were previously associated with the efficacy of nifedipine. Thus it does not seem that nifedipine, in acute tests, has an effect on the pulmonary localisation of scleroderma, at least in the absence of pulmonary arterial hypertension.

Adult↗
PubMed1989

[Pulmonary hemorrhage complicating transthoracic puncture].

Fine needle transthoracic aspiration (FNTA) of pulmonary opacities under guidance of computerized tomography (CT) is a simple procedure yielding conclusive results in many patients with malignant lung tumours. The small caliber of the needles utilized and the CT control make this increasingly popular procedure both accurate and safe. Yet a number of complications have occurred; most of them were benign (e.g. pneumothorax) but some were potentially dangerous (e.g. pulmonary haemorrhage), so that the pros and cons of the procedure must carefully be weighed. We report the case of a patient in whom FNTA was complicated by copious haemoptysis and a pulmonary haematoma clearly visible at CT. The literature concerning the potential complications of transthoracic puncture is reviewed.

Aged↗
PubMed1989

[Value of moderate doses of urokinase combined with heparin in the treatment of massive pulmonary embolism. A retrospective study of 33 cases].

The aim of this retrospective study was to evaluate the efficacy and tolerance of a moderate dose of urokinase (UK : 2000 IU/kg/h) for at least 24 h in a series of 23 patients with massive pulmonary emboli (PE) (mean pulmonary vascular obstruction = 70 +/- 7%). All patients received heparin in conjunction with UK. A control pulmonary angiography, performed at the end of UK therapy, revealed an important decrease in pulmonary obstruction (-50%). One patient died before the end of UK therapy from shock due to PE (early mortality = 4.3%). Severe hemorrhagic complications occurred in 3 patients (13%) and dictated the stoppage of UK administration, but bleeding was never the cause of death or sequelae. Thus, moderate doses of UK associated with heparin appear to effectively induce clot lysis in patients with massive pulmonary emboli. The incidence of hemorrhagic complications should be decreased by strictly respecting all contraindications to the use of thrombolytic agents and by avoiding excessive heparinization.

Adult↗
PubMed1988

[Dosage adjustment of metoclopramide for controlling vomiting induced by cisplatin: pharmacokinetic approach].

Ten patients under cisplatin-containing chemotherapeutic regimens received constant rate continuous infusions of metoclopramide in doses adjusted to each individual case for optimal plasma concentration. Dosage adjustment was based on simple pharmacokinetics with determination of metoclopramide distribution and elimination values in each patient. From these values were calculated the individual loading and maintenance dosages required to obtain the sustained plasma concentration of 0.85 mg/l reported in the literature as being correlated with a good antiemetic effectiveness. The mean plasma concentration in the 10 patients studied was 0.84 +/- 0.19 mg/l with doses which varied considerably owing to marked scattering of pharmacokinetic parameters. Treatment was effective in 6 out of 10 patients and well tolerated by all.

Adult↗
PubMed1988

Cardiac arrhythmias during the combined use of intravenous aminophylline and terbutaline in status asthmaticus.

The purpose of this study was to evaluate prospectively the occurrence of cardiac arrhythmias during the combined therapy with intravenous aminophylline and terbutaline in 29 consecutive patients with status asthmaticus. The 24-hour Holter recordings were performed during continuous intravenous infusions of aminophylline (0.56 +/- 0.20 mg/kg/h) and terbutaline (0.034 +/- 0.014 microgram/kg/min). Serum theophylline concentration was 12.1 +/- 3.8 micrograms/ml and never reached the toxic level (greater than 20 micrograms/ml). Premature ventricular contractions (PVCs) were absent in 35 percent of patients and 48 percent had rare unifocal PVCs (less than 10/h). Only 17 percent of patients (five of 29) exhibited severe ventricular arrhythmias: PVCs greater than 10/h (n = 3), multifocal PVCs (n = 1); and a short run of ventricular tachycardia (n = 1). Serious supraventricular arrhythmias occurred in only 7 percent of patients (two of 29) who developed sustained runs of atrial tachycardia. These arrhythmias were always clinically well tolerated and spontaneously resolved without any antiarrhythmic treatment. We conclude that severe arrhythmias are rarely observed during combined therapy with aminophylline and terbutaline in status asthmaticus.

Adult↗
PubMed1988

[Reduction using an immunomodulator of the level of respiratory infections in chronic bronchitis].

Fifty-six patients with recurrent bronchopulmonary infections associated with chronic bronchitis were randomly allocated to 2 groups, to assess whether treatment with an immunomodulator, Diribiotin CK, could enhance resistance to infection. The double-blind, placebo-controlled prospective trial over a 9 month period showed that this immunomodulator was well tolerated and significantly reduced the rate of respiratory tract infection. The drug also significantly reduced the prescribing of antibiotic medication and the rate of absenteism from work. These effects have been demonstrated in a rigorously designed clinical study. This is the first time that a clear clinical activity has been attributed to an inducer of soluble mediators of immunity.

Adjuvants, Immunologic↗
PubMed1987

Waldenström's macroglobulinaemia in a bird breeder: a case history with pulmonary involvement and antibody activity of the monoclonal IgM to canary's droppings.

A canary breeder with Waldenström's macroglobulinemia developed a pulmonary disease related to an interstitial infiltration by malignant B cells secreting a monoclonal IgM K. The serum monoclonal IgM was shown to possess an antibody activity to some canary's droppings antigen. This finding may help elucidate the natural course of lymphoid malignancies and the pathogenesis of rare visceral localizations.

Adult↗
PubMed1987

[Inhalation pneumonia presenting as a pneumocystis infection].

A case of Pneumocystis carinii pneumonia is presented. Following presentation a chronic alveolitis was uncovered, which was due to ultimately repeated and prolonged inhalation of sweets containing gum arabic. The diagnosis was confirmed by a trans-bronchial biopsy and by chemical analysis of centrifugation of the alveolar lavage deposit. After cessation of the inhalation the progress was satisfactory both in terms of clinical status and lung function measurement.

Gum Arabic↗
PubMed1987

[Theophylline overdoses on admission to a resuscitation unit].

The aim of this study is to assess in a prospective fashion the causes and the frequency of overdosage with Theophylline on admission to intensive care units, in patients on long term treatment with oral Theophylline and/or had previously received an intravenous injection (IV) of Aminophylline. In 72 patients [52 chronic airflow obstruction (or BPCO), 21 asthmatics] admitted for acute respiratory insufficiency (IRA) the blood level of Theophylline on admission to intensive care (T0) was determined systematically, and was in the toxic range (greater than 29 mg/l) in 17% of cases (12/72). In patients with T0 greater than 20 mg/l, repeat measurements of Theophylline clearance were carried out: 12 hours after admission by studying the fall in plasma levels (Cl1), then after 8 days (+/- 5) while perfusing IV Aminophylline at a constant flow (Cl2) and finally after changing over to slow release oral Theophylline 18 days (+/- 10) after admission (Cl3). Cl1 was less than 35 ml/kg/h in 9 patients (group I) and greater than 55 ml/kg/h in 3 patients (group II). All the patients in group I were on oral Theophylline in a dose which was not excessive (mean 10.6 +/- 3.3 mg/kg/24 h) and only one patient received an injection of IV Aminophylline. In group I, the clearance of Theophylline was very low initially (Cl1 = 18.6 +/- 9.6 ml/kg/h) and finally rose (Cl2 = 34.7 +/- 14 ml/kg/h p less than 0.02; and Cl3 = 46.9 +/- 24 ml/kg/h p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1987

[Asthma and pregnancy: peculiarities, therapeutic precautions].

Asthma is a very common disease and may be encountered in pregnant women. The physiological changes which accompany pregnancy, as well as the risks of drug teratogenicity and drug interactions make it necessary to take certain therapeutic precautions. Following a review of the specific respiratory physiological changes observed in pregnant women, the authors describe the risks inherent in the various treatments of asthma and the precautions to be taken during delivery and breast-feeding.

Adrenal Cortex Hormones↗
PubMed1987

[Functional follow-up of pulmonary localization of scleroderma].

Pulmonary lesions of scleroderma are frequent, but little is known of their course, especially where lung function is concerned. We report the results of a longitudinal study performed in 32 patients with generalized scleroderma (ARA criteria) explored on at least 2 occasions with an interval of at least 24 months between the two examinations. Functional alterations seemed to be more pronounced in patients with severe Raynaud's syndrome, but in view of major individual variations no pathognomonic functional profile could be described.

Adult↗
PubMed1986

[Tobacco detoxication by acupuncture and group psychotherapy].

In the out-patient tobacco detoxication unit created, in 1977, within the pneumology department of the Hôtel-Dieu hospital, Paris, the method used is a combination of acupuncture and group psychotherapy. Its effectiveness has been evaluated, over a 2-year period, by means of a questionnaire mailed to each patient and followed, if necessary, by up to 3 reminders. A computer-assisted assessment of the data thus collected provided a follow-up of varying duration of the 555 patients concerned; 488 patients were treated, then contacted, and 371 (76 p. 100) answered the questionnaire. Weaning--defined here as complete detoxication with a 2 to 28 months follow-up when the questionnaire was filled--was obtained in 24 p. 100 of the patients who answered. Other evaluation criteria would have given figures ranging from 18 p. 100 to 58.6 p. 100. The main reason for failure mentioned by the patients was lack of will. An exhaustive study of 84 publications concerning more than 10,000 candidates to weaning showed that similar results are obtained with several types of psychotherapy, acupuncture and auriculotherapy: a success rate of about 60 p. 100 at the end of treatment, 40 p. 100 at 3 months and 30 p. 100 at 6 months and one year. The results obtained with drugs are not as good, perhaps because their use betrays a lesser desire to give up smoking.

Acupuncture Therapy↗